掌侧与背侧经皮入路空芯Herbert螺钉手术治疗新鲜腕舟状骨骨折的临床疗效分析

Comparision of clinical effect between volar and dorsal percutaneous approach with hollow Herbert screws in treating fresh scaphoid fracture

目的：评价掌侧及背侧经皮空芯Herbert螺钉术治疗新鲜腕舟状骨骨折的临床效果。方法：回顾分析我院2008年5月-2014年8月期间收治的新鲜腕舟状骨骨折21例病例，其中9例采用背侧经皮入路空芯Herbert螺钉内固定治疗，12例采用掌侧经皮入路空芯Herbert螺钉内固定治疗。术后按照改良Mayo腕关节功能评分标准来评定、比较两种治疗方法的临床疗效。结果：21例病例术后均获得6个月～24个月随访。21例患者骨折均I期愈合，骨折愈合时间7～12 w，平均9.5 w。改良Mayo腕关节功能评分结果掌侧组：优8例，良3例，可1例，优良率为91.7%；背侧组：优6例，良2例，可1例，优良率为88.9%。经统计学分析，掌侧与背侧经皮空芯Herbert螺钉术治疗腕舟状骨骨折临床疗效比较，差异无统计学意义（P＞0.05）。结论：两种经皮入路方法均疗效确切，术后并发症少，均是临床上治疗腕舟状骨骨折的较为理想的治疗方案。

Objective：To evaluate the clinical effect both of the dorsal and the volar approaches with hollow Herbert screws in treating fresh scaphoid fracture. Methods：Retrospectively analysis 21 patients of fresh scaphoid waist fracture treated with Herbert screws through percutaneous approach during May 2008 to August 2014. The dorsal approach was used in 9 patients,and the volar approach was used in 12 patients. The clinical effect was evaluated by the modified Mayo standard. Results：After follow-up of 6 months to 24 months,fracture primary healing was found in 21 cases. And the fractures were cured within 7～12 weeks（mean 9.5 weeks）. According to the modified Mayo standard：the results（the volar group）were excellent in 8 cases,good in 3 cases,and modest in 1 case,with the effective rate being 91.7%. The results （the dorsal group）were excellent in 6 cases,good in 2 cases,and modest in 1 case,with the effective rate being 88.9%. There was no statistically significant difference between 2 groups in clinical effect （P〉0.05）. Conclusion：Two percuta-neous approach with hollow Herbert screws are effective for fresh scaphoid fracture with few complications. They are both the ideal ways in treating fresh scaphoid fracture.